RCT: Women with post-gestational diabetes benefit from probiotics
Low-grade inflammation is linked to persistent postpartum obesity and GI in women with a previous history of gestational diabetes mellitus (GDM). But probiotics have previously been shown to reduce inflammation, and improve glucose metabolism, and similar positive effects of probiotics have been found in adults with prediabetes and T2DM.
Therefore researchers from the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) (Cheras, Malaysia) conducted a 12-week randomised, double-blind, placebo-controlled clinical trial involving 132 asymptomatic post-GDM women with the aim of discovering how probiotics from Bifidobacterium and Lactobacillus affect the gut microbiota composition and metabolic and inflammatory outcomes in this specific population.
They found that probiotics supplementation significantly decreased FBG, waist circumference, and inflammatory marker high-sensitivity C-reactive protein (hs-CRP) in post-GDM women.
The study
Participants were randomly allocated to the intervention or placebo group on a 1:1 ration. Between three and six months postpartum they either received a cocktail of six probiotic strains or an identical sachet devoid of living microorganisms.
The probiotic supplement was provided by HEXBIO Microbial Cell Preparation (MCP), from B-Crobes Laboratory Sdn. Each sachet of 30 billion colony-forming units (CFU) contained six probiotic strains: Lactobacillus acidophilus, Lactobacillus casei subsp, Lactobacillus lactis, Bifidobacterium bifidum, Bifidobacterium infantis, and Bifidobacterium longum.
Anthropometric measurements, biochemical analyses, and 16S rRNA gene sequencing results were evaluated pre- and post-intervention.
After the 12-week intervention, the probiotics group’s fasting blood glucose level significantly decreased (mean difference −0.20 mmol/L; p = 0.0021).
The HbA1c, total cholesterol, triglycerides, and high-sensitivity C-reactive protein levels were significantly different between the two groups (p < 0.05).
Sequencing data also demonstrated a large rise in the Bifidobacterium adolescentis following probiotic supplementation.
The researchers conclude in their report: "Our findings suggest that multi-strain probiotics are beneficial for improved metabolic and inflammatory outcomes in post-GDM women by modulating gut dysbiosis. This study emphasizes the necessity for a comprehensive strategy for postpartum treatment that includes probiotics to protect post-GDM women from developing glucose intolerance.
"Despite the probiotics group’s minimal changes from baseline in HbA1c, total cholesterol, TG, and IL-8 levels, these outcomes were significantly lower in the probiotics group after the 12-week intervention when compared with the placebo group. Moreover, taking probiotics helped to restore gut microbial profiles, gut microbial functions, and metabolic pathways without having a negative impact on health."
The report points out that the participants in the probiotic group had significantly higher BMI and fiber intake compared with the placebo group and this might have influenced the results. Future researchers are recommended to employ block randomization with stratification (i.e., BMI, age, dietary intake, and physical activity) to ensure equal baseline characteristics. Further studies incorporating a wide participant pool from several centers are also required in order to better determine the functions of probiotics in post-GDM women.
Source: Nutrients
https://doi.org/10.3390/nu14183878 (registering DOI)
"The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial"
Hasain, Z.; Raja Ali, R.A.; Ahmad, H.F.; Abdul Rauf, U.F.; Oon, S.F.; Mokhtar, N.M.
